*DISCLAIMER: Please note I have mentioned routinely used vaccine brands in INDIA as examples. Please do check the ingredients and discuss in detail with your paediatrician before making a decision. We DO NOT promote any brands. This article is only for information and discussion, NOT an advice column.

The combination of diphtheria, tetanus, and pertussis(DPT) vaccines into a single product has been central to the protection of the pediatric population over the past 50 years. The addition of inactivated polio, Haemophilus influenzae, and hepatitis B vaccines into the combination has facilitated the introduction of these vaccines into recommended immunization schedules by reducing the number of injections required and has therefore increased immunization compliance.

What is the advantage of combination vaccines?

Fewer Injections

Reduced trauma to the infant

Higher rate of compliance with complex vaccine schedules

Better vaccine coverage

Timely vaccination – vaccine schedule completed on time

Reduced administration cost

Lower storage space requirement

Allows incorporation of newer vaccines in the schedule

What different types of combinations with DPT which are available in the market?

The commercial vaccines available vary in combinations related to their contents and also differ in costs and side effects.

Previously the vaccines at 6, 10 and 14 weeks were each given separately, in which the DPT vaccine was a very painful one. The pain used to last for 24 hours, associated with fever and irritability. DPT vaccine, is now available in “whole cell” and “acellular forms” i.e pertaining to the type of Pertusis agent used (either DPT or DPaT). The acellular vaccine has fewer side effects. Some forums, mention these two different vaccines as “painful” or “painless”. The difference is that, the acellular vaccine will have less pain and lesser side effects like fever or irritability than the cellular one (but it will pain while administering the injection). DPT(painful) combination vaccine is available in the market as Easy-five® or Pentavac®, while DTaP (painless) combination vaccine is called as Pentaxim®.

What is the difference between Easy-five® or Pentavac® AND Pentaxim®

When you go to the health center to get your baby vaccinated, you will be given an option to choose between Easy-five® (Pentavac®) OR Pentaxim® vaccine. Easy-five® and Pentaxim® both give protection against 5 diseases. Let us see how the two differ:

Easy-five® or Pentavac SD/PFS®

Pentaxim®

Vaccine contains DTP

Vaccine contains DTaP

DTP stands for:

1. Diptheria,

2. Tetanus

3. Pertusis

Easy-five® covers:

1. Diptheria,

2. Pertussis (cellular component), ,

3. Tetanus

4. Haemophilus Influenza type B

5. Hepatitis B.

DTaP stands for

1. Diptheria,

2. Tetanus

3. Acellular Pertusis

Pentaxim® covers:

1. Diptheria,

2. Pertusis (Acellular Component) ,

3. Tetanus,

4. Haemophilus influenza type B

5. IPV (injectable polio vaccine).

Protection offered is similar, but DTP has side-effects like fever and irritability

Does the immunization schedule change on the choice of vaccine depending on if its a painless or painful vaccine?

YES!!!!

It is upto you to decide which vaccine to administer depending on all these factors. If you go for Easy-five®, baby should be given injectable polio vaccine, while in case of Pentaxim® hepatitis-B vaccine must administered separately.

The Schedule of the vaccines will change according to brand of vaccine preferred. I personally preferred Pentaxim® vaccine because of easy availability, easy compliance, lesser post vaccination side effects like fever, irritability etc and there is no confusion regarding the Hepatitis B vaccine schedule. Following is an example of how the schedule will vary according to the type of vaccine:

Easy-five® or Pentavac SD/PFS®

Pentaxim®

Birth

1. BCG

2. OPV – Zero Dose

3. Hep B Vaccine – I

1. BCG

2. OPV – Zero Dose

3. Hep B Vaccine – I

1 Month

—

Hepatitis B – 2

6 Weeks

1. Pentavac -1

2. IPV -1

3. Rotavirus – 1

4. PCV-1 (Can be given now or after 1 week)

1. Pentaxim-1

2. Rotavirus- 1

3. PCV-1 (Can be given now or after 1 week)

10 Weeks

1. Pentavac – 2

2. IPV -2

3. Rotavirus – 2

4. PCV-1 (Can be given now or after 1 week)

1. Pentaxim -2

2. Rotavirus- 2

3. PCV-2 (Can be given now or after 1 week)

14 Weeks

1. Pentavac -3

2. IPV -3

3. Rotavirus – 3

4. PCV-3 (Can be given now or after 1 week)

1. Pentaxim -2

2. Rotavirus- 2

3. PCV-2 (Can be given now or after 1 week)

6 Months

—–

Hepatitis B – 3

Are there any recent studies that show painful vaccine is better than a painless one?

*Thanks a lot for visiting my blog. Please do ‘★ LIKE’ the post if you found it to be useful.Your comments, suggestions, criticism and all opinions are very much appreciated. Please do write your queries in the Reply/comments section and I will try to get back to you asap.

Hi mam
My baby first took easysix vaccine at one hospital but next one we went to government hospital they said there is hexaxim vaccine only available and we took it any problem in that pls help
Regards
PRADEEP

Dear Mam,
i need you opinion. Doctor has given Hexaxim vaccine for my baby on 6th week. Now we are about to go for 10th week vaccine. We are planning to have vaccine in government hsopital. Please let me know is there any problem will occur when we shift from hexaxim vaccine to vaccine provided in the Government hospital.
Regards,
Kumar

Hi, There is no problem on shifting to other vaccines. Only thing, you will have to make sure all the vaccines are covered in the same sitting or after a week, since there will be 2-3 injections now. Other than this no problem.

hi,
for my baby, the next scheduled vaccination is at 14 weeks. in the last two vaccinations (6 weeks and 10 weeks) she was not given IPV 1 and 2.
How should i choose her vaccination schedule for 3 IPV injections starting 14 weeks

Hi,
For my 6 weeks baby we vaccinated
Pentavac,rotavac , synflorix (pcv1) and instead of IPV Dr given OPV so is it O.k and my 2 question is should I go for pentaxim,rotavac and synflorix (pcv2) in 10 th week vaccination

Yes, hepatitis B schedule is 0, 1, 6 months. But since pentavac which already has hepatitis B can be given at 10th week, no harm in it. Do discuss with your pediatrician in detail, regarding the doses and also the 6th month hepatitis B Vaccine.

Sir after birth of baby he has immunised by painful vaccination upto 6month but now we want painless vaccination then it’s ok or we should follow painful vaccination what is good for our baby pls suggest us

ur really awesome the tips u gave here are fabulous . i have given all the vaccination in Government health center
so what is ur view about it . when compared to the private doctors vaccination list? i belong to Chennai actually i am about to put 18 th month vaccination fr my son in next week that is DTP B1
IPV B1 Hib B1.kindly suggest..

Hi,Thanks for the positive input. It is not bad at all to vaccinate your child at a government hospital. Moreover you may get vaccines at a reasonable cost, though some vaccines which do not come under the immunization schedule may be charged or may be unavailable, do take a not of that. Also brands available will be standardised and costly/painless vaccines will not be available. Having said that if you have given all the vaccines at the government set up I suggest you continue the booster doses there itself.

Hi Gauri,
Thanks fir the detailed infirmation.
After checking so many reviews i have found that normal vacination is better than painless. My 6week son git his first painless vacination.
So now can i go with normal vacination and for first vacination do i need to require any booster and when?

Hope you are referring to authentic comparative studies of celluar versus acelluar vaccines and not hearsay reviews, in which case there is only one study published in 2013 that shows the efficacy of painful vaccines ‘slightly’ better than painless vaccines.Overall the efficacy of both vaccines is comparable, not to forget the chance of side effects and distress caused in cellular(painful) vaccines to the baby. There is no such term called as ‘normal’ vaccine. You can shift between the brands, but preferably stick to one brand throughout. No doubt the cost variation is huge, hence do read the whole immunization schedule thoroughly and make a decision. Good Luck!

Yes, preferable you should stick to the same brand. But still it’s ok, sometimes in cases of unavailability of the required brand, doctors switch to others, since all vaccines have to be given on a schedule.

Sir/mam, my baby was given paunfull vaccine first time and later doctors wife (she also doctor) has given painless vacccine. When I asked her, she told there will be no problem. Because brand is different , Medicine is same. Is it correct?

Thanks a lot mam… And third time again went for paunfull vaccine . Now my fear is, because of 2nd dose (painles vaccine -pentaxim) my baby anti bodies can recognise , when virus attacked. Why I’m asking this, some other doctors said….whatever we give first time the same only has to be continued…..plz advice mam….

Hi,
Pentavac SD contains “Diphtheria, Tetanus, Pertussis (Whole Cell),
Hepatitis B (rDNA) and
Haemophilus Type b
Conjugate Vaccine (Adsorbed) I.P.”. Hence additionally injectable polio vaccine (IPV) and oral rotavirus has to be given to the baby at 6, 10 and 14 weeks on the same day or after a week or so of pentavac.

You can check out Justdial or Practo for good Pediatricians (with references and ratings) in Pimpri -Chinchwad, since personally I don’t know anyone in that area.
The price of the above vaccines mentioned by you is the average cost in Pune.
In my opinion all vaccines recommended by IAP should be given, there is nothing more important than the health of a baby (buy less toys if necessary 🙂 ). Still if cost is the constrain, then I suggest you complete the Rotavirus vaccination atleast.

Universal Immunization Programme (UIP) is a vaccination program launched by the Government of India in 1985. The program now consists of the following:
1. BCG (Tuberculosis)
2. DPT (diphtheria, pertussis (whooping cough), tetanus)
3. OPV (poliomyelitis)
4. Measles
5. Hepatitis B
6. Japanese Encephalitis (In high risk cases)
7. TT (in pregnant and booster doses for kids)
In 2014 it was announced that more vaccines will be added to the program, namely rotavirus, rubella and injectable polio vaccineFrom February 2017, Union ministry of health and family welfare will roll out Measles-Rubella vaccine from UIP. Hence UIP consists of most important vaccines which are provided free of cost at health centres.
Whereas IAP also recommends Pneumococcal 13-valent Conjugate Vaccine (PCV) , chicken pox vaccine and MMR instead of Measles at 9 months.
Private practitioners also recommend Flu vaccines (optional) and also there is an option of Painless vaccines.

thanks a lot
very informative article.
i have given my baby ist dose of easy five at 6 week . we have shifted to another city where doc recommend pentaxim. we injected it as it was less painful. now for 3rd dose im not sure which one to give easy five or pentaxim. and wht abt hep b schedule if i prefer pentaxim or easy five in last dose.will there be any difference.

Thanks for your detailed explanation about vaccines. Now, I have a 3 months old daughter. The first DTP vaccine was given by a pediatrist on my daughter’s buttocks. He said that the ones giving vaccine on thighs are useless. Then 2nd vaccine was given by another doctor. He gave vaccine on her right thigh and when inquired, he said that the vaccine given on buttocks are useless. Kindly enlighten me about this.
Thanks

Well the vaccines, specially dtp is no more recommended to be given on buttocks. It is said that the fat in the buttock reduces the absorption of the vaccine. So the current recommended practice s to give t on the thigh

Hi Gauri, really a very informative
Post all my doubts about painless and painful vaccines are clear now thank u very much!
With this detail have decided to go for painful one however my daughter’s first vaccine is painless so is that fine if I choose painful one from now onwards I.e. 10th week vaccine.
Please help me here.
Also not sure if iam correct in the beginning you have mentioned DTPs available in d market as short list ,in that pentaxim and pentavac combinations are in contradict with the details explained below, have a look not sure though.

Hi Sindhu,
Thank you for your kind words.
1) As you have already vaccinated your child using pentaxim, changing to Pentavac may change her vaccine schedule, hence you can discuss this with her pediatrician. As far as I know, you can give her three painless vaccine with one booster dose of painful vaccine (Some pediatricians recommend this)
2) And yes there was typing error as you mentioned, which I have now corrected. Thanks for noticing.